Did you know that about 20 percent of adults in the United States report some degree of hearing loss? By the time people reach age 65, that number rises to 1 in 3.

As an audiologist, there are many common questions I receive about hearing loss, so I want to share those—and their answers—with you.

1. Can hearing loss be prevented?
The single most important thing we can do to prevent hearing loss--or additional hearing loss--is to avoid noise exposure. This applies to industrial noise, lawn mowers, leaf blowers, motorcycles, iPods, etc.

A rule of thumb is that if you are standing next to a person and have to raise your voice for them to hear you, the noise is more than likely affecting your hearing. Also, if you are next to someone listening to music on headphones, and you can hear the music, too, it’s too loud and is likely affecting the listener’s hearing. Hearing loss is not reversible, but further loss can be prevented.

2. Besides exposure to loud/chronic noise, what else can cause hearing loss?
The cochlea, which is part of the inner ear, is adversely affected if it doesn’t receive adequate blood supply. Chronic conditions that affect blood circulation, such as high blood pressure, diabetes and other cardiovascular issues, can decrease the blood supply to the cochlea. This decrease in blood supply can lead to increased hearing loss.

The best way to prevent this is to lead a healthy lifestyle. Control your diabetes, blood pressure and other chronic conditions through proper use of medication, as well as dietary and physical activity recommendations.

3. Can hearing loss run in families?
Most people over the age of 65 have SOME hearing loss. Risk is increased by having a family history of hearing loss and by a history of noise exposure.

I will say this….most of my hearing-impaired patients also have relatives with hearing impairment.
Recurrent ear infections can lead to hearing loss, and the tendency for ear infections can also run in families. An ear infection is caused by fluid behind the ear drum which has become infected. If untreated over a long period of time, it can lead to damage to the bones in the middle ear, resulting in possible permanent hearing loss.
Initially, an ear infection is treated with antibiotics. If the infection doesn’t improve over a period of time, then ventilating tubes are inserted into the ear drums. These tubes act as an artificial Eustachian tube to allow air to enter the middle ear space and prevent further fluid build-up.

Ventilating tubes are not recommended after only one episode of ear infection, but are indicated when there are recurrent ear infections that do not respond to medication.

In children with recurring middle ear disease (frequent ear infections), there is a dysfunction of the Eustachian tube. The dysfunction is related to the structure of the face, which is influenced by heredity, and therefore, tends to run in the family.

4. How are hearing issues detected?
Family members are usually the first to notice an individual’s hearing loss. They complain that a person isn’t hearing well or does not understand what is being said. The person with hearing loss often thinks they are fine, and everyone is mumbling.

Because hearing loss is most often a very gradual process, the person with the loss is not as aware of the problem as are the people around them.

5. Are there any warning signs of hearing loss?
“Ringing” or other noises in the ear are often an indicator of damage to the cochlea. Once there is a suspicion of hearing damage/loss, the next step is a formal evaluation.

6. How is hearing loss evaluated?
When a person believes they need to be tested for hearing loss, the first step is a visual exam of the ear canal to rule out the presence of excessive ear wax. (If that is the problem, it can be taken care of with a careful cleansing.)

Hearing is initially tested using a range of sounds to determine how well a person can detect sound at various volumes and pitches. We also measure how a person hears speech overall, and how well they understand different words. By that I mean a person is presented with a list of words at an average conversational level to measure how clearly they hear speech.

For some patients, further testing is indicated. For example, impedance audiometry is utilized to measure Eustachian tube dysfunction. This test determines if there is middle ear fluid, or a hole in the eardrum. It also measures the movement of the bones in the middle ear. The middle ear has a muscle reflex, and the absence of that reflex can indicate a problem with a hearing nerve.

These exams can help determine if the hearing loss is due to a cochlear change or a middle-ear problem. If it is due to a cochlear change, then it is a permanent loss that may be best addressed with a hearing aid; a middle-ear problem may be able to be corrected by treatment with an ear, nose and throat specialist.

Testing you children can be difficult, so we use a test called visual enforcement audiometry. In this test, the sounds are not presented through earphones, but through loud speakers in a sound booth. When the child turns toward the appropriate loud speaker when the sound is presented, a moving toy is illuminated to reinforce his/her response. This test can be done as young as six months, assuming the child has the physical ability to move their neck/head to turn toward the speaker.

7. If someone is reluctant to get a hearing aid, what can I tell them that might make them at least consider the idea?
Hearing aids changed dramatically in 1996, when the first digital hearing aid was commercially available.

The fidelity (reproduction of sound) of newer hearing aids is VERY much improved over old technology. The aids are much more flexible in terms of fine-tuning the aid to accommodate the person’s specific hearing loss. Their ability to help people understand speech and noise is much better than it was with analog hearing aids. This is primarily due to dual microphone technology. Additionally, “open fit slim tube” aids are commonly used, which are much less conspicuous than previous options

8. If a person has a hearing loss, will being fitted with a hearing aid prevent their hearing loss from becoming worse?
Hearing aids do not prevent a hearing loss from progressing. However, in measuring hearing loss, we look at how a person hears conversational and environmental sounds, and also how well one understands speech. This ability is not only related to our ears, but also our brain, which is the interpreter of sound. In other words, our brain provides meaning to what our ear hears. If a person has not heard certain sounds in a long time, the brain becomes “rusty,” and it takes longer to re-learn how to interpret the incoming sound.

Successfully adjusting to hearing aids is often easier for a person who has had a hearing loss for a shorter, rather than longer, period of time.

9. Does a daily aspirin contribute to hearing loss over time?
A daily aspirin will not contribute to hearing loss. For aspirin to cause hearing loss, it would have to be many aspirin per day, according to studies on body weight and dosage.
I hope this information has been helpful. Addressing hearing loss, while not always comfortable for family members and friends, can help someone lead a more fulfilling, social life.

----

If someone is struggling with a hearing loss, he/she may be a good candidate for low-cost hearing screening appointments, offered regularly at Deaconess Clinic in the audiology department. Please visit www.deaconess.com/calendar. You may also call the screening registration appointment line at (812) 450-6000.